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Vitamin D deficiency in South-East Asian children: a systematic review
  1. Vicka Oktaria1,2,
  2. Dwi Astuti Dharma Putri2,
  3. Zulfikar Ihyauddin2,
  4. Madarina Julia3,
  5. Dian Caturini Sulistyoningrum4,
  6. Poh Bee Koon5,
  7. Margaret Danchin6,7,8,
  8. Indah Kartika Murni2,3
  1. 1Department of Biostatistics, Epidemiology and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sleman, Daerah Istimewa Yogyakarta, Indonesia
  2. 2Center for Child Health-Pediatric Research Office, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sleman, Daerah Istimewa Yogyakarta, Indonesia
  3. 3Child Health Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sleman, Daerah Istimewa Yogyakarta, Indonesia
  4. 4Department of Nutrition and Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sleman, Daerah Istimewa Yogyakarta, Indonesia
  5. 5Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Selangor, Malaysia
  6. 6Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
  7. 7Murdoch Children's Research Institute, Melbourne, Victoria, Australia
  8. 8Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia
  1. Correspondence to Dr Vicka Oktaria, Department of Biostatistics, Epidemiology and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sleman, Daerah Istimewa Yogyakarta, Indonesia; vicka.oktaria{at}ugm.ac.id

Abstract

Objective To describe the prevalence and determinants of vitamin D deficiency (VDD) among healthy children aged between 0 and 18 years living in South-East Asia (SEA).

Design We systematically searched Ovid MEDLINE and Ovid EMBASE for observational studies assessing VDD among healthy children in the SEA region as the primary or secondary outcome from database inception to 6 April 2021. PubMed was used for e-pubs and publications not indexed in Medline. Publications that included abstracts in English were included. We performed a systematic review to describe the prevalence of VDD in SEA children.

Results Our initial search identified 550 publications with an additional 2 publications from manual screening. Of those, 21 studies from 5 different countries (Thailand, Indonesia, Vietnam, Malaysia and Cambodia) were summarised and included in forest plots. The prevalence of VDD (<50 nmol/L) ranged from 0.9% to 96.4%, with >50% of newborns having VDD, and severe VDD (<30 nmol/L) ranged from 0% to 55.8%. Female sex and urban living were the most common determinants of VDD.

Conclusions VDD among healthy children living in the SEA region is common. Efforts to detect VDD and the implementation of preventive measures, including education on safe sun exposure and oral vitamin D supplementation or food fortification, should be considered for key target groups, including adolescent females and pregnant and lactating women to improve the vitamin D status of newborns.

Protocol registration number This study is registered with PROSPERO (CRD42020181600).

  • child Health
  • epidemiology
  • paediatrics

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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Footnotes

  • Contributors Conceptualisation: VO, MJ, DCS, MHD, IM. Data curation: VO, DADDP, ZI. Formal analysis: VO, DADDP, ZI. Supervision: IM, MJ, MHD. Writing—original draft: VO. Writing—review and editing: VO, MD, IM, MJ, DCS, DADDP, ZI, BKP. Guarantor: VO.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.